Monthly Employee Contribution of 5% (as of current rate)

Health             Dental             Vision

Employee only                         $39.04             $1.99               $0.49

Employee/spouse                    $81.99             $4.09               $1.01

Employee child(ren)                $74.18             $3.38               $0.83

Employee/spouse/child(ren) $126.89           $5.33               $1.28